BPP1984
... ... - - -
a I [ k~ r;) !":. H~: ~ J Effra L'- q 4 (oeJ
PLUM:BING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195 P 1984
(402) 426-4191
Application Date: ;:l ~ ;;2// '-01
Job Address
Owner
1.
Contractor
Comments:
Notice
I hereby certifY that I have read and examined this
application and know the same to be true and correct. All
provisions oflaws and ordinances goveming this type of
work will be complied with whether specified herein 01'
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
PermitFee: $ &1), 00 ~'
Phone
',LP
Phone
v /33/1c1 J7.f. 33 D .~ 61 70
o Repair 0 Replacement
Jrtn
PLUMBING PERMIT FEES
Modular Home....... ..,.. ..,... ....$50.00
Type of Fixture No.
Kitchen...... ...... ...... ......... '.. $12.00 x
Bath... ..Residential/Single Stall $12.00 x_
.., ,,' ..,..,.., ,....Multi-Stall $25.00 x
Rough-InBath....... ...,.............$8.00 x_
Additional Sinlcs....... ... .......... .$6.00 x
Slop Sink/Laundry Tray/Drain....,$6.00 x_
Water Heater.,. ...... .'. ... ... "."..$10,00 x
Outside Water Faucet.............,.....$6,00 x
Drinking Fountain......,......,..........$6.00 x_
Backflow/Grease Trap.,...." ... ..$15.00
Water Service.,.... .... .,... ........$15.00
Sewer............................. ....$15.00
Groundwork...................... ...$15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System.. . . . . . . , , . .$1 0.00
Sprinkler System (Commercial)..$30.00 ~
Gas/Water Piping System
(Commercial)...."..........,...,. ..$50.00
ci3o, 00
Permit Issuance Fee,.. ...... ....... .$25.00
. ,c.?t::;>
- ,el()
Cun-ent License on File
Comment:
Total
l$(Yes 0 No 0 NjA
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By:
. d5 < ? <.fl.i.JJ~r{-'
I
Rev. 2008-10
PLUMBING PERMIT APPLICATION
Jurisdiction of City of Blair, Nebraska
218 South 16th Street
Blair, Nebraska 68008
Fax (402) 426-4195
(402) 426-4191
Application Date: ;:? ~ ;?// --01
Job Address
Owner
1.
Contractor
Comments:
Notice
I hereby certifY that I have read and examined this
application and know the same to be true and correct. All
provisions oflaws and ordinances governing this type of
work will be complied with whether specified herein or
not. The granting of a permit does not presume to give
authority to violate or cancel the provisions of any other
state or local law regulating construction or the
performance of construction.
Signature of Contractor or Authorized Agent
Date
P 1984
()
Permit Fee: $ 55.0
Phone
Phone
v /33/1c1 J7.f. 33 D -~ 6'/70
o Repair 0 Replacement
(
<...Vf11
PLUMBING PERMIT FEES
Modular Home... ... ......... ... ....$50.00
Type of Fixture No.
Kitchen............................. .$12.00 x
Bath.....Residential/Single Stall $12.00 x_
................. ...Multi-Stall $25.00 x
Rough-In Bath...................... ..$8.00 x_
Additional Sinks............. ..... ...$6.00 x
Slop Sink/Laundry Tray/Drain.....$6.00 x_
Water Heater..................... ....$10.00 x
Outside Water Faucet...................$6.00 x
Drinking Fountain........................$6.00 x_
Backflow/Grease Trap............ .$15.00
Water Service............... ...... ..$15.00
Sewer............................. ....$15.00
Groundwork...................... ...$15.00
Septic Tank & Laterals............ $15.00
Lawn Sprinkler System... ....... ..$10.00
Sprinkler System (Commercial)..$30.00 ~
GasIWater Piping System
(Commercial)............ ..... ... ....$50.00
,30.00
Permit Issuance Fee......... ....... .$25.00
Current License on File
Comment:
Total
l$(Yes 0 No 0 NjA
- ,c)(?
el{)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
I Approved By: 6 < !? J 1,..ih.4A]cl-
Rev. 2008-10